光线跟踪引导或 Q 值调整 FS-LASIK 矫正近视和近视散光：对侧眼比较研究。

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2024-11-01 DOI:10.3928/1081597X-20240917-01

Yifei Yuan, Ruiyu Zhang, Zizhen Wang, Yuexin Wang, Yu Zhang, Yueguo Chen

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引用次数: 0

摘要

目的：比较个体化光线跟踪引导的飞秒激光辅助原位角膜磨镶术（FS-LASIK）矫正近视和近视散光的安全性和有效性：这项前瞻性、随机、双盲、对侧眼研究包括 34 位需要 FS-LASIK 治疗的近视或近视散光患者的 68 只眼睛。每名患者的一只眼被随机分配接受光线跟踪引导治疗，而对侧眼则接受Q值调整消融治疗。在术前和术后 3 个月的随访中，对患者的未矫正远距离视力（UDVA）、矫正远距离视力（CDVA）、球面等效屈光度（MRSE）、球面、柱面、有效光学区（EOZ）和 6 毫米角膜像差进行了测量和分析：术后 3 个月，光线跟踪组 94% 的眼睛和 Custom-Q 组 85% 的眼睛的 UDVA 均达到或优于 20/16（P = 0.064）。光线跟踪组中有 47% 的人的 CDVA 增加了一条或多条斯奈伦线，Custom-Q 组中有 32% 的人的 CDVA 增加了一条或多条斯奈伦线（P = .043）。Custom-Q组的MRSE、屈光散光、手术引起的散光和差异矢量更好（P < .05）。光线追踪组的术后角膜HOA和光路差明显更好（P = .008）。光线追踪组和定制-Q组的EOZ分别为5.77毫米和5.43毫米（P < .001），光线追踪组和定制-Q组的平均消融深度分别为100.97微米和85.24微米（P < .001）：尽管存在过度矫正和过度消融角膜组织的情况，但在临床实践中发现，光线跟踪引导的 FS-LASIK 对于有散光和无散光的近视矫正都是安全有效的，尤其是在实现 UDVA 和减少角膜 HOA 及 OPD 方面。[J Refract Surg. 2024;40（11）：e804-e813]。

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Ray-tracing-Guided or Q-Value-Adjusted FS-LASIK for Correction of Myopia and Myopic Astigmatism: A Comparative Contralateral Eye Study.

Purpose: To compare the safety and efficacy of individualized ray-tracing-guided femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of myopia and myopic astigmatism.

Methods: This prospective, randomized, double-blind, contralateral eye study included 68 eyes of 34 patients with myopia or myopic astigmatism requiring FS-LASIK treatment. For each patient, one eye was randomly assigned to receive the ray-tracing-guided treatment, whereas the contralateral eye underwent Q-value-adjusted ablation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), sphere, cylinder, effective optical zone (EOZ), and 6-mm corneal aberrations were measured and analyzed before operation and after a 3-month postoperative follow-up.

Results: At 3 months postoperatively, the UDVA of 20/16 or better was measured in 94% of eyes in the ray-tracing group and 85% of eyes in the Custom-Q group (P = .064). Forty-seven percent in the ray-tracing group and 32% in the Custom-Q group gained one or more Snellen lines of CDVA (P = .043). The MRSE, refractive astigmatism, surgically induced astigmatism, and difference vector were better in the Custom-Q group (P < .05). The postoperative corneal HOAs and optical path difference were significantly better in the ray-tracing group (P = .008). The EOZs of the ray-tracing and Custom-Q groups were 5.77 and 5.43 mm (P < .001), and the average ablation depths of the ray-tracing and Custom-Q groups were 100.97 and 85.24 µm (P < .001), respectively.

Conclusions: Despite the overcorrection and excessive ablation of corneal tissue, ray-tracing-guided FS-LASIK in clinical practice was found to be safe and effective for myopic correction both with and without astigmatism, particularly in achieving UDVA and inducing fewer corneal HOAs and less OPD. [J Refract Surg. 2024;40(11):e804-e813.].

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.